The human cost

The distance between Mariam Tamimi’s village of Nabi Salih and the hospital she needed to reach in Ramallah is not more than 20 kilometres. Such a short distance should take only 20 minutes: easily enough for Mariam to reach Ramallah hospital and receive urgently needed treatment for her heart condition.

But such a conjecture is relevant only in normal circumstances. This does not allow for the abnormal, and — to an outsider — unfathomable route that someone like 55 year old Mariam and her family are confronted with when undertaking such a critical journey.

Mariam Tamimi was not given the chance to receive her treatment. Delays on the road prevented her timely arrival, and cost her her life. The delays could — and should — have been avoidable. They were the whim of Israeli soldiers at two of the military checkpoints between Nabi Salih and Ramallah. For, despite family members describing the severity and urgency of Mariam’s condition, the Israeli soldiers refused to let them pass, and insisted on holding up the car.

Mariam Tamimi is the seventeenth Palestinian to have died since last September because delays at Israeli military checkpoints in the occupied Palestinian territories have prevented access to medical treatment. Not one of these civilians was involved in clashes or resistance to the occupation. And this figure is only part of a far greater picture of the fatal effect of Israeli imposed closure on access to health care facilities in the West Bank and Gaza Strip.

The reality of Palestinian daily life continually demonstrates appalling violations to this fundamental human right. Over 70 per cent of the Palestinian population live in rural areas, which provide nothing more than the most basic medical services. Closure therefore has a serious effect on Palestinian civilians’ access to vital secondary and tertiary health care facilities. In addition to cases such as Mariam’s, those requiring ongoing treatment, for example for kidney failure, or cancer, suffered extreme hardship and deterioration of their conditions when attempting to leave their villages. Pregnant women have been severely affected: the United Nations Relief Works Agency (UNRWA), reports a 58 per cent increase in the number of stillbirths and four cases of childbirth occurring at military checkpoints. The Union of Palestinian Medical Relief Committees reports a 100 per cent increase in home deliveries. UNRWA also reports a decrease in preventive services, including a 52 per cent decrease in women attending postnatal care. Both organisations also point to their fluctuating inability to implement vaccination schemes, attendance at which fell 12 per cent in the first four months of the Intifada; this obstruction can only lead to greater health care problems in the future.

The Israeli imposed closure of the Palestinian territories is not only internal. Closure of international borders, cutting the West Bank and Gaza Strip from the rest of the world, has prevented Palestinians from receiving specialised medical treatment abroad in at least 90 cases. Problems await even the few lucky enough to be given permits to travel abroad for medical treatment: 64 year old Fatima Sharafi died at the Rafah border crossing in the Gaza Strip. She was returning from treatment at Egypt’s Nasser Hospital but was fatally delayed for several days at the border as she tried to re- enter Gaza to return home.

These figures do not record the effect of the Israeli closure on the provision of emergency medical care: there have been at least 164 incidents of denial of access to Palestinian Red Crescent Society (PRCS) ambulances. Possibly more frightening are PRCS reports of direct attacks on medical personnel. For example, on 25 January four PRCS medics were intercepted at a checkpoint by the Israeli army, forced out of their vehicle, stripped, searched and beaten for over four hours.

These facts alone — quite aside from the disastrous economic effects of closure on Palestinians — surely warrant a reaction from the international arena, not least from the US, whose own constitution clearly upholds equality of human rights.

The Israeli government is clearly acting in contravention of international law, violating article 17 of the 1949 Fourth Geneva Convention which states: “The parties to the conflict shall endeavour to conclude local agreements for the removal from besieged and encircled areas, of wounded, sick, infirm and aged persons, children and maternity cases and for the passages of all religious, medical personnel and medical equipment on their way to such areas.”

For the Palestinians, in their struggle against occupation, the road ahead is long, in more ways than one. Now, as it is made ever more arduous in its physical form, the humanitarian effects of closure and siege — as witnessed in the health sector — are only too apparent. For as long as the Israeli government is allowed to impose this system of collective punishment — bordering individuals with roadblocks and military checkpoints — the price paid in innocent human lives will continue to increase. One is left asking how many more people will have to go through an ordeal such as Mariam’s before the international community is shamed into upholding some of those human rights it takes such pride in writing into its constitutions and conventions.

Dr. Mustafa Barghouthi is President of the Union of Palestinian Medical Relief Committees.

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